Open-Ended and Open-Door Treatment Groups for Young People with Mental Illness

Abstract

The concept of open-ended groups is expanded to include an open-door model (OEOD) wherein members with severe mental illnesses, including schizophrenia disorders and bipolar, can join, leave, and reenter groups as their life circumstances dictate their availability and willingness for treatment. This model is grounded on the work of Schopler and Galinsky's (1984/2006) and Galinsky and Schopler's (1989) theses on the value and processes of open-ended groups and includes perspectives on mutual aid and group development. Groupwork with the OEOD format is illustrated with examples taken from a group of 79 participants diagnosed with first-episode schizophrenia/schizoaffective disorders, 40 of whom had cooccurring substance abuse. Of the 79 participants in the OEOD group program, 70 (89%) remained in treatment for the maximum of 3 years. The overall value of group treatment for this population is reviewed along with the small number of available publications on open-ended and open-door type groups.

Keywords:

• groupwork
• schizophrenia
• open-ended
• open-door
• mental illness

Acknowledgments

We wish to acknowledge Delbert Robinson, MD, Joanne McCormack, MSW, and Serge Sevy, MD, for supporting our work with participants of the groups described. The views of the authors do not necessarily represent the views of the National Institutes of Health. Funding was provided by the NIMH Grant MH60004, MH41960, NIH Grant RR018535-01 and by NIDA Grant K23DA015541.